Development and feasibility study of a Culturally Tailored Asthma intervention using a mixed-method approach at the primary school level in Malaysia: Challenged by the COVID-19 pandemic.

Introduction: The World Health Organization recommends incorporating asthma programmes into national school health services, although this recommendation is rarely implemented. Methods: In Malaysia, we developed a multi-level primary school asthma programme incorporating educational sessions for children with asthma and their parents, raising awareness within the whole school community and training school staff to provide first-aid asthma management. The programme was adapted for delivery during the COVID-19 pandemic, and a mixed-method feasibility study was conducted in October 2020. Results: We identified 34 children with asthma, who comprised 3.7% of the school population. Only 14/34 (41.2%) children with asthma and 4/14 (28.5%) of their parents attended the remote sessions. The in-person session for school staff was attended by 55/62 (88.7%), among whom 86.0% rated the session as good/excellent. Conclusion: The school-based intervention was feasible and received good feedback, despite the COVID-19 pandemic forcing remote delivery. Stakeholder engagement is essential in the development and feasibility of a school-based asthma programme.